Nursing Elites

1. What advice should the client be given if they are feeling dizzy upon standing after taking a diuretic for hypertension?

• A. Avoid standing up too quickly.
• B. Increase fluid intake to stay hydrated.
• C. Eat more salt to help retain fluids.
• D. Wear compression stockings during the day.

Correct answer: A

Rationale: The correct advice for a client feeling dizzy upon standing after taking a diuretic for hypertension is to avoid standing up too quickly. Diuretics can lead to orthostatic hypotension, causing dizziness upon sudden position changes. Increasing fluid intake can exacerbate the issue by further lowering blood pressure. Eating more salt might counteract the diuretic's effects but is not the primary intervention for orthostatic hypotension. Compression stockings are more relevant for venous insufficiency than for orthostatic hypotension.

2. A client has been coughing for 3 weeks and is beginning to cough up blood. The client has manifestations of which of the following conditions?

• A. Allergic reaction
• B. Ringworm
• C. Systemic lupus erythematosus
• D. Tuberculosis

Correct answer: D

Rationale: The correct answer is D: Tuberculosis. Coughing up blood (hemoptysis) is a key symptom of tuberculosis. Tuberculosis is a respiratory infection caused by the bacterium Mycobacterium tuberculosis. The other options are incorrect because an allergic reaction typically involves symptoms like itching, hives, or swelling, not coughing up blood. Ringworm is a fungal skin infection characterized by a red, circular rash, and systemic lupus erythematosus is an autoimmune disease that primarily affects joints and skin without causing hemoptysis.

3. A client with type 2 diabetes mellitus is receiving metformin (Glucophage). Which laboratory test should the LPN/LVN monitor while the client is taking this medication?

• A. Complete blood count (CBC)
• B. Liver function tests
• C. Serum electrolytes
• D. Renal function tests

Correct answer: B

Rationale: The correct answer is B: Liver function tests. While a client is taking metformin, monitoring liver function tests is crucial to assess for potential hepatic side effects. Metformin is primarily eliminated by the liver, and monitoring liver function tests helps in early detection of any liver-related complications. Choices A, C, and D are incorrect. A complete blood count (CBC) is not specifically required for monitoring metformin therapy. Serum electrolytes are not directly impacted by metformin, making it less relevant for monitoring this medication. Renal function tests are important for some other diabetes medications, but in the case of metformin, liver function tests take precedence due to its hepatic metabolism.

4. During a peripheral vascular assessment, a healthcare professional places the bell of the stethoscope on a client's neck and hears an audible vascular sound associated with turbulent blood flow. This sound indicates which of the following?

• A. Narrowed arterial lumen
• B. Distended jugular veins
• C. Impaired ventricular contraction
• D. Asynchronous closure of the aortic and pulmonic valve

Correct answer: A

Rationale: The correct answer is A: Narrowed arterial lumen. Arterial bruits are abnormal sounds caused by turbulent blood flow through narrowed or occluded arteries. This turbulent flow creates a blowing sound, which is heard as an arterial bruit. Distended jugular veins (choice B) are typically associated with venous issues, not arterial abnormalities. Impaired ventricular contraction (choice C) and asynchronous closure of the aortic and pulmonic valve (choice D) are not directly related to the audible vascular sound described in the scenario.

5. A nurse manager is assigning care of a client who is being admitted from the PACU following thoracic surgery. The nurse manager should assign the client to which of the following staff members?

• A. Charge nurse
• B. Registered nurse (RN)
• C. Practical nurse (PN)
• D. Assistive personnel (AP)

Correct answer: B

Rationale: In this scenario, a client who has undergone thoracic surgery and is being admitted from the PACU requires a high level of nursing care. Registered nurses (RNs) have the education and training necessary to provide the complex care and monitoring needed for a post-thoracic surgery client. Charge nurses may oversee units but may not always be directly involved in providing bedside care. Practical nurses (PNs) have a different scope of practice compared to RNs and may not have the advanced skills needed for post-thoracic surgery care. Assistive personnel (AP) provide valuable support but do not have the qualifications to manage the care of a client following thoracic surgery.

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